Department of Obstetrics and Gynecology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, P.R. China.
Department of Pathology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, P.R. China.
J Ovarian Res. 2021 Apr 17;14(1):53. doi: 10.1186/s13048-021-00805-0.
Ovarian sex cord stromal tumours (OSCSTs) are rare ovarian tumours and include different histopathologic subtypes. This study aimed to analyse the clinical and sonographic characteristics of different histopathologic OSCST subtypes.
A total of 63 patients with surgically proven OSCSTs were enrolled in this retrospective study to analyse their clinical and sonographic features. Ultrasound examinations and predictive models were performed before surgery. The clinical and sonographic findings were compared according to the type of OSCST based on the histopathological diagnosis.
The mean age of 63 patients was 52.17 years (range: 17-78 years). Eighteen patients experienced irregular vaginal bleeding (28.57% 18/63), 7 patients exhibited abnormal body hair (11.11%). 2 patients (3.17%) showed an increased level of CA125, and 25 patients (39.68%, 25/63) showed an increased level of testosterone. Forty-two patients had ovarian thecoma-fibroma groups (OTFGs). Six patients had Sertoli-Leydig cell tumours (S-LCTs), 4 patients had Leydig cell tumours (LCTs), 8 patients had ovarian granulosa cell tumours (OGCTs), 2 patients had ovarian steroid cell tumours, not otherwise specified (OSCTs-NOS), and one patient had sclerosing stromal tumours (SSTs). The mean diameter of the tumour was 47.9 mm (range: 10-258 mm). Forty-seven masses were hypoechoic (74.60%). Twenty-eight masses had posterior echo attenuation, 22 masses exhibited abundant Doppler flow signals (34.92%), and one patient had ascites (1.59%). The diagnostic accuracy of the Simple Rules (SR) and the Assessment of Different NEoplasias in the adneXa (ADNEX) model in distinguishing benign and malignant OSCSTs was 44% (30/63) and 84% (53/63), respectively. The diagnostic accuracy of the SR for OTFGs, S-LCTs & LCTs & OSCTs-NOS, OGCTs, and SSTs was 47.6% (20/42), 16.67% (2/12), 100% (8/8), and 0% (0/1), respectively. The diagnostic accuracy of the ADNEX model for OTFGs, S-LCTs & LCTs & OSCTs-NOS, OGCTs, and SSTs was 93% (31/42), 58.33% (7/12), 75% (6/8), and 100% (1/1), respectively.
OSCSTs generally appear as a solid mass on ultrasound. Posterior echo attenuation indicates an OTFG. A solid mass with abundant Doppler flow signals indicates an S-LCT, LCT, OSCT-NOS or OGCT. Current predictive models are not very effective, but symptoms, sonographic features and serum hormones are helpful for diagnosis.
卵巢性索间质肿瘤（OSCST）是一种罕见的卵巢肿瘤，包括不同的组织病理学亚型。本研究旨在分析不同组织病理学 OSCST 亚型的临床和超声特征。
本回顾性研究共纳入 63 例经手术证实的 OSCST 患者，分析其临床和超声特征。在术前进行超声检查和预测模型。根据组织病理学诊断，根据 OSCST 类型比较超声表现。
63 例患者的平均年龄为 52.17 岁（范围：17-78 岁）。18 例患者出现不规则阴道出血（28.57%，18/63），7 例患者出现异常体毛（11.11%）。2 例患者（3.17%）出现 CA125 水平升高，25 例患者（39.68%，25/63）出现睾酮水平升高。42 例患者为卵巢颗粒细胞瘤-纤维瘤组（OTFGs）。6 例患者为 Sertoli-Leydig 细胞瘤（S-LCTs），4 例患者为 Leydig 细胞瘤（LCTs），8 例患者为卵巢颗粒细胞瘤（OGCTs），2 例患者为卵巢类固醇细胞瘤，未特指（OSCT-NOS），1 例患者为硬化性间质瘤（SSTs）。肿瘤的平均直径为 47.9mm（范围：10-258mm）。47 个肿块呈低回声（74.60%）。28 个肿块有后向回声衰减，22 个肿块有丰富的多普勒血流信号（34.92%），1 个患者有腹水（1.59%）。简单规则（SR）和附件不同肿瘤评估（ADNEX）模型在鉴别良恶性 OSCSTs 中的诊断准确率分别为 44%（30/63）和 84%（53/63）。SR 对 OTFGs、S-LCTs 和 LCTs 及 OSCT-NOS、OGCTs 和 SSTs 的诊断准确率分别为 47.6%（20/42）、16.67%（2/12）、100%（8/8）和 0%（0/1）。ADNEX 模型对 OTFGs、S-LCTs 和 LCTs 及 OSCT-NOS、OGCTs 和 SSTs 的诊断准确率分别为 93%（31/42）、58.33%（7/12）、75%（6/8）和 100%（1/1）。
OSCSTs 通常在超声上表现为实性肿块。后向回声衰减提示 OTFG。实性肿块伴有丰富的多普勒血流信号提示 S-LCT、LCT、OSCT-NOS 或 OGCT。目前的预测模型不是很有效，但症状、超声特征和血清激素有助于诊断。
